Valutazione partecipata dei Centri diurni di Salute mentale di Roma

An evaluation Research on the Day Centers of mental health of Rome was carried out using a multi stakeholder approach. The thesis presents three distinct studies. In the first study the structural aspects of the day centers were investigated. Re-sults point towards a lack of personnel power, an increase of time in care taking, the lack of activities supporting self-help and – in many cases – the lack of users’ participation in the planning and supervision of their own therapeutic project. Further, the day centers’ lack of integration in the territory was a problem of almost all day centers under study; only the network with the other psychiatric services was well developed, In the second study users’, operators’ and family members’ representations of the day centre were analyzed; additionally a set of goals of the ideal and actual day centre was surveyed. Main goal and purpose of the participative evaluation study must lie in the establishment of stake holders’ different criteria for the eval-uation of the day centre. The free association data we collected to the primer “day centre” clearly showed the centrality of “socialization” as a closely associated concept to the day centre. “Socialization” is further reflected for each stakeholder group more specifically as “friendship” for users, “welcoming [it.: accoglienza]” for operators and “help” as well as “obligation” for family members. Further dif-ferent, and well distinct conceptions of the day centre emerged: The day centre as an (.) educative (.) entertaining (.) therapeutic (.) or rather assisting facility. Enter-taining, pedagogism as well as terapism were the most developed conceptualiza-tions of the day centers. In the third study, based on the analysis of focus groups the critical issues with respect to the day centers were investigated. Especially, problems related to the stigma of chronic illness and issues emerging from pharmacological treatments were often discussed. The conclusions of this thesis point towards the need for a reorientation of the day centers: they emerged as segregating rather than socially integrating struc-tures. This is mainly due to the fact that most activities are carried out insider the services, characterized by a rigid and horizontal management. The day centers will have to change into flexible structures, characterized by an increased co-management by users as well as the promotion of self-help groups. dipartimento per le politiche sociali del Comune di Roma, nell’ambito del Progetto di valutazione dei Centri diurni di salute mentale di Roma, svolto dall’ISTC-CNR